 <!DOCTYPE html>
<html lang="zh" xmlns:th="http://www.thymeleaf.org" >
<head>
    <th:block th:include="include :: header('随访满意度评价')" />
</head>
<style>

</style>
<script>

</script>
<body>
    <div class="ui-layout-center">
        <form class="form-horizontal" id="form-followUpEvaluation-edit" th:object="${user}">
            <h4 class="form-header h4">基本信息</h4>
            <input type="hidden" id="id" name="id" th:value="${id}">
            <div class="row">

                <div class="col-sm-12">
                    <div class="form-group">
                        <!--is-required 增加星号 显示为必填-->
                            <label class="col-sm-1 control-label">患者姓名：</label>
                            <div class="col-sm-2">
                                <div class="input-group">
                                    <input name="patientName" placeholder="患者姓名" th:value="${patientName}" class="styled-input" type="text" maxlength="255" required>
                                </div>
                            </div>
                            <label class="col-sm-1 control-label">随访任务：</label>
                            <div class="col-sm-2">
                                <div class="input-group">
                                    <input name="followUpTask" placeholder="随访任务" th:value="${followUpTask}" class="styled-input" type="text" maxlength="20" required>
                                </div>
                            </div>
                        <label class="col-sm-1 control-label">任务跟进人：</label>
                        <div class="col-sm-2" >
                            <div class="input-group">
                                <input name="taskFollower" placeholder="任务跟进人" th:value="${taskFollower}" class="styled-input" type="text" maxlength="20" required>
                            </div>
                        </div>
                        <label class="col-sm-1 control-label">评价日期：</label>
                        <div class="col-sm-2">
                            <div class="input-group">
                                <input name="evaluationDate" placeholder="评价日期" th:value="${evaluationDate}"
                                       class="styled-input time-input" type="text" required>
                            </div>
                        </div>
                    </div>
                </div>
                <div class="col-sm-12">
                    <div class="form-group">
                        <label class="col-sm-1 control-label">连锁：</label>
                        <div class="col-sm-2">
                            <div class="input-group">
                                <input name="chainStoreName" placeholder="连锁" class="styled-input" th:value="${chainStoreName}" type="text" maxlength="255" required>
                            </div>
                        </div>
                        <label class="col-sm-1 control-label">门店：</label>
                        <div class="col-sm-2">
                            <div class="input-group">
                                <input name="storeName" placeholder="门店" th:value="${storeName}" class="styled-input" required>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </form>
    </div>
    <div class="main-content">
        <div class="col-sm-offset-5 col-sm-10">
            <button type="button" class="btn btn-sm btn-primary" onclick="submitHandler()"><i class="fa fa-check"></i>保 存</button>&nbsp;
            <button type="button" class="btn btn-sm btn-danger" onclick="closeItem()"><i class="fa fa-reply-all"></i>关 闭 </button>
        </div>
    </div>
	<th:block th:include="include :: footer" />
</body>
</html>

<script>
    function submitHandler() {
        var prefix = ctx + "dtp/pmService";
        if ($.validate.form()) {
                var data = $("#form-followUpEvaluation-edit").serializeArray();
            /*var status = $("input[id='status']").is(':checked') == true ? 0 : 1;
            var roleIds = $.form.selectCheckeds("role");
            var postIds = $.form.selectSelects("post");
            data.push({"name": "status", "value": status});
            data.push({"name": "roleIds", "value": roleIds});
            data.push({"name": "postIds", "value": postIds});*/
            $.operate.saveTab(prefix + "/followUpEvaluationEdit", data);
        }
    }
</script>
